It is assumed that fertility issues are mainly associated with women, but the truth is that both female and male factors may contribute to an inability to conceive and carry pregnancy. Also, for those who are struggling to conceive, infertility is common, and nearly 15% of the couples have trouble conceiving or carrying to full term. Busting popular myth, infertility is not a female issue alone, but almost a third of the cases are due to male infertility. Read on to learn more about the causes of male and female infertility.
Infertility diagnosis happens when a woman is unable to get pregnant after trying for a year. If you are a woman over 35 years of age and not able to conceive even after 6 months or 1 year, then it means you may have fertility problems. Women who can conceive but are unable to carry a pregnancy to childbirth may have fertility problems. A woman who has not got pregnant even once may be diagnosed with primary infertility. If she has at least one pregnancy and is unable to carry the second one, then it will be called secondary infertility.
Infertility may not always be a woman's problem; it can be due to male infertility, too. Women and men are likely to have fertility problems equally. About one-third of the cases can be due to female infertility, and another third is due to male infertility. The remaining cases are a combination of female and male infertility, or the cause may be unknown. The common risk factors that affect both genders are:
● Age (women over 35 and men over 40)
● Weight issues
● Diabetes
● Eating disorders
● Sexually transmitting infections
● Cancer treatments/Radiation therapy
● Alcohol or substance abuse
● Smoking
● Over-exercise
● Stress
● Issues with sperm production
● Problems with sperm quality and sperm count
● Abnormal sperm shape
● Motility issues include wriggling motion and sperm transport from the male reproductive system through the tubes.
● Swelling of the testicular veins or varicocele
● Retrograde ejaculation which is a medical condition
● Testicles that have not descended into the scrotum
● Low testosterone production
● Antibodies that attack and destroy the sperm
● Cancer treatment like radiation or chemotherapy
● Medications for ulcerative colitis, rheumatoid arthritis, antidepressants, high blood pressure calcium channel blockers, and anabolic steroids used for performance enhancement or delayed puberty.
● Recreational drugs like cocaine and marijuana.
Any or a combination of the above causes and risk factors could cause male fertility issues.
● Conditions like PCOS (polycystic ovary syndrome) or hormonal imbalances.
● Fallopian tube blockage
● Egg issues; time of release, quality, and implantation problems
● Ovulation problems
● Deficient growth of uterine lining
● PID (pelvic inflammatory disease)
● Uterine fibroids
● Premature ovarian failure
● Endometriosis
● Injury from previous surgery
● Radiation and chemotherapy for cancer treatment
● Long-term use of high-dosage NSAIDS (nonsteroidal anti-inflammatory drugs)
● Recreational drugs like cocaine and marijuana
● Antipsychotic medications
Among them, ovulation problems are one of the major problems, and the two significant signs of this are absent or irregular periods, which cause ovulation issues.
If you are unable to conceive despite trying for many months, you are likely to be recommended tests to determine your fertility. Here are some tests the doctor may prescribe.
Men should consult a doctor after a year of trying to have a baby or if they have:
● Low sex drive
● Erectile dysfunction
● Swelling or pain in the genitals
● Problems with ejaculation
● Have had surgery previously in the genital area.
During the visit, your caregiver will take your medical history, and you will be asked about your sexual health, overall health, and factors that affect fertility. A physical examination is done to check for any structural issues or lumps.
A semen analysis will be done where you have to give a sample of your semen. This will be checked in a lab for sperm quality, quantity, structure and motility. Depending on the semen analysis and the initial exam, additional tests may be recommended. These tests are:
● Hormone testing
● Genital ultrasound
● Genetic testing
As women age, their fertility decreases, especially after 30. So, women who are less than 35 should consult a doctor after a year of trying for pregnancy. Women over 35 should visit after 6 months. When you consult a doctor, you will be asked about your medical history, current health status, sexual history, family history and any illness or condition that can cause female infertility. A pelvic examination is done to check for fibroids or conditions like endometriosis. A blood test or a home ovulation testing kit can be used to determine if you are ovulating. An ultrasound may be done to check the uterus and ovaries. Other tests include:
● A type of X-ray called hysterosalpingography to check the uterus and fallopian tube
● To check the internal organs, laparoscopy is one.
● Ovarian reserve testing, which is a combination of tests which includes hormone tests, is conducted to check your potential for conceiving.
Depending on the test results, your specialist may offer many treatment options. It ranges from lifestyle changes, ovulation induction, IUI (intrauterine insemination) & IVF. Choosing fertility treatment can be a tough decision, with factors like success rate, side effects and cost plays a significant role. Talk to your partner and doctor to decide which treatment is best.
If you are still wondering if infertility is how Common in men or women, we must conclude that it has definitely increased over the years. Fertility is likely to decline with age and this effect is much greater in women. Having an infertility diagnosis does not mean your dream of having a child ends. It takes time, but many couples with fertility issues have succeeded in having a child some with medical assistance and some on their own.
As per stats, one in seven couples worldwide experience infertility.
Environmental factors, lifestyle factors and women preferring to have children later in their lives are some of the reasons why infertility is common.
Secondary infertility, the inability to become pregnant or carry it to term, affects 11% of couples in India, as per stats.
